Friday, August 3, 2012

Abstract:
Open defecation (OD) is a large global problem, but it is substantially and importantly an Indian problem: about 60 percent of the approximately 1 billion people who defecate in the open live in India. Widespread OD has major consequences for health and human capital in India. Ending OD and pursuing feasible methods of safe excreta disposal are therefore important policy priorities. This paper draws policy lessons from the first ten years of latrine construction under a flagship program of the Indian government, the Total Sanitation Campaign (TSC). So far, the TSC has been able to improve average health and human capital among Indian children where it has been implemented, even though sanitation coverage remains substantially incomplete. The first ten years of the TSC will have, on average, prevented an infant death for a few thousand dollars, a comparatively very inexpensive average cost. This initial success is in part due to the Nirmal Gram Puraskar (NGP), an incentive for village governments. Heterogeneity in the intensity and effectiveness of TSC implementation suggests that the additional benefits of extending effective TSC implementation to the many remaining Indian children would probably substantially exceed the additional costs. Therefore, as the TSC becomes the Nirmal Bharat Abhiyan, India should not miss the opportunity to invest in successful principles of total sanitation: quality data, effective monitoring, and motivational ex post incentives.